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Psychiatry"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the adaptability of Comprehensive Behavioral Intervention for Tics (CBIT) for a Chinese population, and evaluate the efficacy of combined CBIT and pharmacotherapy (CBIT + PT) compared to CBIT or pharmacotherapy (PT) alone for reducing tics and for improving the quality of life (QoL) in a sample of Chinese children with chronic tic disorders (CTD) and Tourette syndrome (TS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>In this 10-week randomized controlled pilot trial, 37 outpatients aged between 6 and 16 years affected by TS and CTD were randomly assigned to receive CBIT (<jats:italic>n<\/jats:italic> = 22) or PT alone (<jats:italic>n<\/jats:italic> = 15). Considering the feasibility, the patients allocated to the CBIT treatment group could further choose whether to simultaneously take medicine voluntarily, resulting in a CBIT alone group (<jats:italic>n<\/jats:italic> = 12) and a CBIT + PT group (<jats:italic>n<\/jats:italic> = 10).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, no significant difference was found between the three groups in the demographic and clinical characteristics (<jats:italic>p<\/jats:italic> &amp;gt; 0.05). All three groups showed a significant reduction in tic severity after treatment assessed by the Yale Global Tic Severity Scale (YGTSS) severity score [<jats:italic>F<\/jats:italic><jats:sub>(2<\/jats:sub>,<jats:sub>33)<\/jats:sub> = 35.05, <jats:italic>p<\/jats:italic> &amp;lt; 0.001, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.51], the score of the Clinical Global Impression scale for Improvement (CGI-I) [<jats:italic>F<\/jats:italic><jats:sub>(1<\/jats:sub>,<jats:sub>34)<\/jats:sub> = 13.87, <jats:italic>p<\/jats:italic> = 0.001, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.29], and YGTSS impairment score [<jats:italic>F<\/jats:italic><jats:sub>(2<\/jats:sub>,<jats:sub>33)<\/jats:sub> = 31.71, <jats:italic>p<\/jats:italic> &amp;lt; 0.001, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.48]. Significant interactions were found between the time-point and group in emotional functioning [<jats:italic>F<\/jats:italic><jats:sub>(2<\/jats:sub>,<jats:sub>29)<\/jats:sub> = 4.39, <jats:italic>p<\/jats:italic> = 0.02, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.23], psychosocial functioning [<jats:italic>F<\/jats:italic><jats:sub>(2<\/jats:sub>,<jats:sub>29)<\/jats:sub> = 5.93, <jats:italic>p<\/jats:italic> = 0.007, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.29], and total QoL score [<jats:italic>F<\/jats:italic><jats:sub>(1<\/jats:sub>,<jats:sub>34)<\/jats:sub> = 3.72, <jats:italic>p<\/jats:italic> = 0.04, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.20] of Pediatric Quality of Life Inventory (PedsQL 4.0) for children suggesting a significantly larger improvement in emotional functioning, psychosocial functioning, and total QoL score of the life quality in the CBIT group for children self-report. PedsQL for proxy report only showed a significant main effect of time-point in physical functioning [<jats:italic>F<\/jats:italic><jats:sub>(1<\/jats:sub>,<jats:sub>33)<\/jats:sub> = 8.35, <jats:italic>p<\/jats:italic> = 0.01, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.2], emotional functioning [<jats:italic>F<\/jats:italic><jats:sub>(1<\/jats:sub>,<jats:sub>33)<\/jats:sub> = 10.75, <jats:italic>p<\/jats:italic> = 0.002, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.25], psychosocial functioning [<jats:italic>F<\/jats:italic><jats:sub>(1<\/jats:sub>,<jats:sub>34)<\/jats:sub> = 11.38, <jats:italic>p<\/jats:italic> = 0.002, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.26], and total Qol score [<jats:italic>F<\/jats:italic><jats:sub>(1<\/jats:sub>,<jats:sub>34)<\/jats:sub> = 13.21, <jats:italic>p<\/jats:italic> = 0.001, \u03b7<jats:italic><jats:sub><jats:italic>p<\/jats:italic><\/jats:sub><\/jats:italic><jats:sup>2<\/jats:sup> = 0.29].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CBIT is probably effective in reducing tic severity in Chinese children with tic disorders. CBIT + PT may not be superior to CBIT alone in reducing tic severity and improving quality of life. CBIT alone showed advantages in improving quality of life over CBIT + PT and PT alone. CBIT might be an appropriate treatment option for patients with tic disorder in Chinese mainland.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.997174","type":"journal-article","created":{"date-parts":[[2022,11,11]],"date-time":"2022-11-11T04:41:53Z","timestamp":1668141713000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["A preliminary study of comprehensive behavioral intervention for tics in Chinese children with chronic tic disorder or Tourette syndrome"],"prefix":"10.3389","volume":"13","author":[{"given":"Wen","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenqing","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingjing","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinhua","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,11]]},"reference":[{"journal-title":"The Fifth Edition of the diagnostic and statistical manual of mental disorders (DSM-5).","first-page":"947","year":"2013","key":"B1"},{"key":"B2","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1007\/s00787-021-01845-z","article-title":"European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. 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